Quality Standards for Dementia Care

Health Quality Ontario is the province’s advisor on health care quality. Their mandate is to monitor, assess and provide guidance on important health quality issues and to work together with patients to bring about meaningful improvements. They have provided the following 14 Quality Statements for patients receiving care in in hospitals and residents in long-term care homes. Health Quality Ontario website »

Reference Guide

Quality Statements For Patients

1. Comprehensive Assessment
You should receive an examination and full assessment every time you arrive at or leave a hospital or long-term care home. An assessment means that your care team will want to learn more about you to understand how best to help you. It should include questions about your physical health, your medical history, what medications you’re taking, how you spend your time, and how you’re feeling.

2. Individualized Care Plan
A care plan should be created to meet your individual needs. A care plan is a written statement that describes the care you receive, who provides it, and what medications you are on. It is based on your full assessment.

3. Individualized Nonpharmacological Interventions
There are a variety of nonpharmacological interventions that can be effective in managing symptoms of agitation or aggression in people living with dementia. Treatment approaches should include a combination of nonpharmacological interventions that are individualized based on the person’s needs, symptoms, preferences, and history. Nonpharmacological interventions may be oriented to the senses (e.g., aromatherapy, multisensory therapy) or cognition (e.g., reminiscence therapy) and should have demonstrated effectiveness in improving behavioural and psychological symptoms of dementia. Recreational activities and exercise may also improve a person’s ability to function and their quality of life.

4. Indications for Psychotropic Medications
Medications should be used only if you are in severe distress or if there is a concern you might harm yourself or someone else.

5. Titrating and Monitoring Psychotropic Medications
If they are used, medications should be started at a low dosage and gradually increased until your symptoms improve.

6. Switching Psychotropic Medications
Your team of health care professionals should help you find the right medication to fit your needs.

7. Medication Review for Dosage Reduction or Discontinuation
There should be a regular review of your medications to see if the dosage can be reduced or the medications stopped altogether.

8. Mechanical Restraint
You should not be physically restrained.

9. Informed Consent
No changes should be made to your treatments until you have been given information about their benefits and harms and have agreed to these changes. In very rare circumstances, where someone is at risk of being hurt, you might be treated first and then provided with information as soon as possible.

10. Specialized Interprofessional Care Team
You should receive care from a team of health care professionals who have been trained to care for people living with dementia.

11. Provider Training and Education
You should receive care from a team of health care professionals who have been trained to treat symptoms of agitation and aggression.

12. Caregiver Training and Education
Support and information should be provided to your family and other people who care for you so they can help you in the best possible way.

13. Appropriate Care Environment
If needed, you should be transferred to an environment that is calm with minimal noise or activity that disturbs you.

14. Transitions in Care
You should have a smooth transition between care environments.